SESSION TITLE: Quality & Clinical Improvement Posters I
SESSION TYPE: Original Investigation Poster
PRESENTED ON: Wednesday, October 29, 2014 at 01:30 PM - 02:30 PM
PURPOSE: Motor vehicle collisions are a leading cause of traumatic injury in the United States; while the probability of a pedestrian collision has declined in recent years, the probability of a pedestrian fatality has risen. Our objective is to determine whether advanced age impacts morbidity and mortality in patients involved in low-speed pedestrian-struck motor vehicle collisions.
METHODS: We performed a retrospective study of all adult patients aged > 14 years involved in a low-speed pedestrian-struck motor vehicle collision (<15 miles per hour) who presented to an urban level-I trauma center over the course of January 2013 to November 2013. Subjects were identified via the trauma registry and stratified into two groups: those aged 15-49 years and those aged ≥50 years. Medical records were reviewed for demographics, vital signs and laboratory results on initial presentation, presence or absence of systemic inflammatory response syndrome (SIRS), shock index (SI), injury severity score (ISS), length of stay (LOS), and survival to discharge. Statistical analysis was performed using chi-square analysis or t-test as appropriate.
RESULTS: Our sample included 145 patients, 68 male and 77 female, with a mean age of 41.9 ± 3 years. Ninety-five patients were aged 15-49 years (mean 31.9 ± 2.2 years) and 50 patients were aged 50 years or older (mean 62.44 ± 2.9 years). Mean ISS was 10.05 ± 1.95, mean SI was 0.68 ± 0.03, and mean LOS was 3.67 ± 0.57 days. Forty-one patients were found to meet SIRS criteria on arrival; nine patients expired (6.2% mortality). Mean ISS (15.64 ± 4.42 vs 7.1 ± 1.64, p<0.001) and mean SI (0.75 ± 0.07 vs 0.65 ± 0.03, p=0.002) were higher in patients aged ≥50 years. Mean LOS was longer in patients aged ≥50 years (5.22 ± 1.14 vs 2.85 ± 0.58 days, p<0.001). Age ≥ 50 years was found to be positively correlated with SIRS on arrival (p=0.023) and negatively correlated with survival to discharge (p=0.004).
CONCLUSIONS: Age ≥50 years is correlated with greater traumatic injury and suboptimal outcomes in patients involved in low-speed pedestrian-struck motor vehicle collisions as measured by ISS, shock index, SIRS on initial presentation, length of stay, and survival to discharge. Further large-scale research would be necessary to determine whether these findings are reproducible.
CLINICAL IMPLICATIONS: Advanced age (≥50 years) is correlated with morbidity and mortality in patients involved in pedestrian-struck low-speed motor vehicle collisions.
DISCLOSURE: The following authors have nothing to disclose: Amy Pate, Srilakshmi Ponukumati, Akella Chendrasekhar
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